Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $712.79 / $3,455.00 / $10,893.00	Facility		$712.79	$3,455.00	$10,893.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $776.00 / $776.00 / $3,919.50	Facility	50	$776.00	$776.00	$3,919.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $486.63 / $661.35 / $996.00	Professional		$486.63	$661.35	$996.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $405.48 / $1,060.33 / $1,060.33	Professional	50	$405.48	$1,060.33	$1,060.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $680.35 / $680.35 / $922.35	Professional	50	$680.35	$680.35	$922.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,780.38 / $3,076.97 / $6,214.00	Facility		$1,780.38	$3,076.97	$6,214.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.08 / $619.14 / $970.17	Professional		$460.08	$619.14	$970.17
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $769.00 / $1,898.10 / $3,240.00	Facility		$769.00	$1,898.10	$3,240.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $519.16 / $660.74 / $877.85	Professional		$519.16	$660.74	$877.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $423.31 / $1,632.25 / $1,632.25	Facility		$423.31	$1,632.25	$1,632.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,263.04 / $1,263.04 / $1,304.32	Facility		$1,263.04	$1,263.04	$1,304.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $499.28 / $696.21 / $1,010.25	Professional		$499.28	$696.21	$1,010.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,445.08 / $26,542.00 / $26,542.00	Facility		$3,445.08	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,659.44 / $4,682.96 / $5,376.15	Professional		$3,659.44	$4,682.96	$5,376.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $503.88 / $694.12 / $1,089.76	Facility		$503.88	$694.12	$1,089.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $535.49 / $778.90 / $1,063.49	Professional		$535.49	$778.90	$1,063.49
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $419.30 / $419.30 / $419.30	Professional	50	$419.30	$419.30	$419.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $471.96 / $620.58 / $783.67	Professional		$471.96	$620.58	$783.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $503.88 / $701.69 / $1,134.74	Facility		$503.88	$701.69	$1,134.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.15 / $712.18 / $1,044.98	Professional		$512.15	$712.18	$1,044.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,326.00 / $7,600.00	Facility		$1,120.00	$3,326.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $495.33 / $660.44 / $982.56	Professional		$495.33	$660.44	$982.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $603.09 / $848.18	Professional		$533.91	$603.09	$848.18